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Sexually Transmitted Diseases - STDs


In February 2002 the British Medical Association (BMA) Science Department and Board of Science and Education published a document called 'Sexually Transmitted Infections'.

Along with all other viral sexually transmitted diseases, HIV once contracted is a life-long disease - there is no cure.  The report does not state that HIV in itself is not a killer disease but it does state that it 'progressively weaken the body's immune system and when the damage is so great that opportunistic infections and tumours develop, the criteria for acquired immune deficiency syndrome (Aids) is met'.  The report then continues by saying 'People who become infected with HIV may have no symptoms for ten or more years, but they can still transmit the infection to others'.  There is no indication in the report as to the short or long term consequences of how HIV affects the functioning and harmful effects of other sexually transmitted diseases.

What studies have been done on HIV sufferers with Herpes or Syphilis, Chlamydia, Gonorrhoea or any combination of any or all the sexually transmitted diseases?  Does, for instance, someone with HIV have a different response to anti-viral drugs that they may be taking for Herpes?  Do these drugs slow down the replication of HIV in the body?  If the person then stops the drugs because the symptoms of Herpes have subsided, does the HIV then speed up in its replication in the body?  Would taking these drugs for other sexually transmitted diseases actually mask the possible symptoms of HIV or does everyone going for tests for any sexually transmitted disease automatically have an HIV test?  It is very highly unlikely that each of these infections are only contracted in isolation.  Yet as the report states, an HIV sufferer may have no symptoms for ten or more years.  If there are no symptoms, people will not go for treatment or even for testing.

The symptoms of HIV, when they do appear, are so completely different from other forms of sexually transmitted diseases as they just make the sufferer feel unwell, or it takes longer to get better following a simple cold.  Other forms of sexually transmitted diseases often are more easily identifiable with pain, sores, or discharges of one sort or another, although some of these also have no symptoms, especially in the case of Chlamydia.  Who pays for all these tests?

The report says that HIV is transferred from one person to another through sexual contact, including vaginal and anal sex, or by sharing contaminated needles/syringes.  It doesn't say if any other STIs are transferred via the sharing of needles or syringes.  Could the reason for the acknowledgement that HIV can be spread via shared needles/syringes be precisely because the HIV virus is so small, prolific and undetectable by living in the circulating blood whereas other sexually transmitted diseases attach themselves to the outer skin or inner organs where they spread and cause damage?  The report also says that transmission through oral sex is rare but it can occur, although how this can be proved is not stated.  HIV can also be spread in infected pregnant women to their baby during pregnancy, at delivery as well as through breast-feeding.

The report says 'Other transmission methods are rare in the UK and include accidental needle-stick injury, artificial insemination through donated semen, donated organ transplant or by transfusion of contaminated blood, although all donors are now screened for HIV infection prior to donation in the UK.'  How is this carried out?  Is it just a finger prick prior to the actual giving of blood that shows if someone is HIV positive?  If an infection doesn't show up for 10 years, how can anyone be sure blood is not contaminated?  Is the blood checked once it is given?  How can it be confirmed that a single HIV virus particle has not been missed in the full amount of blood given?  Every last drop surely, would need to be thoroughly checked with high precision instruments that could detect single HIV virus particles.  Similarly for donated organs and semen.  The actual donor may be giving the blood, or semen in the assumption that they do not have HIV in their system.  There are certain criteria that prevents some people from giving blood in case it may be infected (see our Blood Transfusion page), but this is done trusting that the donor is telling the truth.

The report continues by saying 'Almost all HIV infected people will eventually develop Aids if they are not treated.  Common bacteria, yeast, parasites, and viruses that ordinarily do not cause serious disease in people with fully functional immune systems can cause fatal illnesses in people with Aids.'  Although this statement could be referring to illnesses such as the common cold or flu, it is probably referring to other sexually transmitted diseases that between them are bacterial, yeast based, parasitical and viral, especially as many of these diseases will be contracted at the same time and not in isolation.  So if someone has various sexually transmitted diseases, that they may or may not know about, then they have sex with someone who is HIV positive, who may or may not realise they are, the likelihood of a serious disease is more likely to develop into full blown AIDS (Acquired Immune Deficiency Syndrome) that will eventually lead to their death.  It is quite probable that anyone contracting HIV will also contract other sexually transmitted diseases if they have not already done so, if they are participating in casual or even 'safer' sex.

Even more worryingly the report then says 'HIV infection may initially cause an illness, which is often mild, consisting of muscle aches, low-grade fever, headaches and sometimes a rash.  Swelling of the lymph glands may also occur.  This illness (sero-conversion illness) is so like many other viral infections that the diagnosis of HIV infection may be missed at this time.  It can take the immune system up to three months to produce antibodies to HIV and therefore a negative HIV test result within this period may be misleading and should be repeated.  The virus can be transmitted before sero-conversion takes place and recent research has indicated that viral load can be very high, and transmissions accordingly more likely, during this period than during the later asymptomatic HIV positive period.'  So if someone has flu like symptoms the HIV diagnosis may be missed presumably unless the person concerned makes it known that they suspect they may have contracted HIV.  Yet even then the test would need to be repeated if the antibodies didn't show up the first time.  In the meantime, the high viral load which makes transmission to someone else more likely will be passed on for others to contract HIV.  Condoms, which are supposed to prevent sexually transmitted diseases and sperm from passing through will continue to be used despite the fact that they tear, slip off, and can have naturally occurring holes which are at least 50 times larger and up to 500 times larger than the HIV virus (see our Could Condoms Leak HIV? page).  Yet condom use is still promoted as the responsible action for 'safer sex'.  The report fails to say how many people may have contracted HIV while using a condom and how many were aware that the condom failed at the time.  Are people even asked if they use a condom?  What percentage do use condoms and what percentage use them occasionally and what percentage don't use them at all?

The report goes on to say 'Once an individual is diagnosed, a number of tests monitor the stage of the disease and indicate when treatment should be started to prevent illness (including Aids).'  What is the frequency of these tests?  Are similar tests carried out on the partner(s) of the individual so see if HIV has spread?  What if the partner is unknown or unwilling to have the tests?  Will there come a time when people are coerced into having tests against their will - similar to abortions being carried out on women in China who haven't permission from the state to have a child at that time?  Who pays for these tests - the government or the individual whose lifestyle may be the reason why they have contracted the disease?

The use of HAART (Highly Active Antiretroviral Treatment) has apparently transformed HIV infection from 'an invariably fatal illness to a treatable chronic condition in which good health can be restored.  However, about 25 per cent of new HIV cases are now found to be resistant to one or more antiviral agents used in treatment, and many others may develop antiviral resistance if patient adherence to treatment is suboptimal.  Long term prognosis in treated patients remains uncertain.'  Why are 25% of new cases already resistant to antiviral drugs?  Could it possibly be due to them already having taken so many antibiotics to cure other sexually transmitted diseases that when HIV is detected the body's system has already built up a resistance to certain drugs?  The other 75% of patients can be treated but may develop resistance to the antiviral drugs.  Could those patients who develop resistance be the same patients who have other sexually transmitted life-long viruses that are contributing to the resistance?  Are all these drugs free to patients in the UK or would the patient have to at least pay the standard prescription charge?  What about those in third world countries where HIV is spreading, particularly Africa - are the HAART drugs available to them, and at what cost and to whom?  How many of those HIV/Aids sufferers also have other sexually transmitted diseases, and what treatments do they have access to?  Is condom failure a contributory factor in the high rise of HIV/Aids throughout the world?

The report, in a footnote, states 'Aids was first recognised in 1981 and today (2002) over 36 million people are estimated to be infected with HIV worldwide (World Health Organisation and UNAIDS: WAD Epidemic Report).  In the UK, HIV is now being diagnosed more frequently in heterosexual than in homosexual men.  The number of reported diagnoses of HIV infection attributed to heterosexual exposure rose from around 100 in 1986 to over 1,000 in 1999.  (Public Health Laboratory Service: HIV/Aids surveillance in the United Kingdom).'

Are you aware that HIV testing is now recommended, according to the report, as part of the routine antenatal screen for all pregnant women?  Does this include married women where neither she nor her husband have ever had any other partner?  Are pregnant women told that one of the 'standard' tests they undergo is for HIV?  What other tests for sexually transmitted diseases are carried out as standard?  On whose authorisation are these test carried out?  Who has access to these results?  Is there a privacy or Human Rights issue here?  What if the pregnant woman doesn't wish to have such a test done?  Is it done anyway?  Is this test done in the local hospital or the GPs surgery?  Where are the tests sent to be checked?  How accurate are the results bearing in mind that even before sero-conversion diagnosis may be missed in people who having casual sex, let alone pregnant women who may never have been at risk?  Assuming a pregnant women is found to be HIV, is her partner/husband then called in for a test?  Could a possible previous relationship be something that the women had not wanted her partner/husband to know about?

The report says that the recently published government sexual health strategy aims to increase genitourinary medicine (GUM) clinic testing for HIV, with a view to reducing by 50 per cent the proportion of attendees unaware of their infection.  It also aims to promote and support testing for HIV in primary care and other medical settings.  Does this mean that anyone going to their GP will automatically have to have a test for HIV?  Will this then become a required part of an annual check-up to make sure any HIV is found as soon as possible?  Once someone has been diagnosed with HIV how will this affect any future life insurance or job prospect?  Will HIV sufferers be obliged to reveal this information and to whom and in what circumstances?

The question has to be asked - do the numbers of sufferers warrant the expense spent on HIV/Aids or should part of the Government money be better used to inform people of the real consequences of all sexually transmitted diseases of which HIV is just one and the rest of the money be spent of non-sexual activity healthcare?

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